Increased procalcitonin level is a risk factor for prolonged fever in children with Mycoplasma pneumonia

• Main Authors: Ji Eun Jeong, Ji Eun Soh, Ji Hee Kwak, Hye Lim Jung, Jae Won Shim, Deok Soo Kim, Moon Soo Park, Jung Yeon Shim
• Format: Article
• Language: English
• Published: Korean Pediatric Society 2018-08-01
• Series: Korean Journal of Pediatrics
• Subjects: Pneumonia; Procalcitonin; Drug resistance; Child
• Online Access: http://kjp.or.kr/upload/pdf/kjp-2018-61-8-258.pdf
• ISSN: 1738-1061; 2092-7258

Purpose Macrolide-resistant Mycoplasma pneumoniae pneumonia (MPP) is characterized by prolonged fever and radiological progression despite macrolide treatment. Few studies have examined serum procalcitonin (PCT) level in children with MPP. We aimed to investigate the association of acute inflammation markers including PCT with clinical parameters in children with MPP. Methods A total of 147 children were recruited. The diagnosis of MPP relied on serial measurement of IgM antibody against mycoplasma and/or polymerase chain reaction. We evaluated the relationships between C-reactive protein (CRP), PCT, and lactate dehydrogenase (LDH) levels and white blood cell (WBC) counts, and clinical severity of the disease. We used multivariate logistic regression analysis to estimate the odds ratio for prolonged fever (>3 days after admission) and hospital stay (> 6 days), comparing quintiles 2–5 of the PCT levels with the lowest quintile. Results The serum PCT and CRP levels were higher in children with fever and hospital stay than in those with fever lasting ≤ 3 days after admission and hospital stay ≤ 6 days. CRP level was higher in segmental/lobar pneumonia than in bronchopneumonia. The LDH level and WBC counts were higher in children with fever lasting for >3 days before compared to those with fever lasting for ≤ 3 days. The highest quintile of PCT levels was associated with a significantly higher risk of prolonged fever and/or hospital stay than the lowest quintile. Conclusion Serum PCT and CRP levels on admission day were associated with persistent fever and longer hospitalization in children with MPP.